Concurrent palliative radiation with pembrolizumab for platinum-refractory urothelial carcinoma is associated with improved overall survival

•We investigated the hypothesis that palliative radiation to patients treated with pembrolizumab exerts a favorable effect on survival in 235 platinum-refractory metastatic urothelial carcinoma patients.•Overall survival from the initiation of pembrolizumab was significantly longer in patients who underwent concurrent palliative radiation with pembrolizumab than in both patients with palliative radiation before pembrolizumab and those without palliative radiation throughout the follow-up.•The result using propensity score matching still exhibited a longer overall survival in patients treated with concurrent palliative radiation with pembrolizumab than those without concurrent palliative radiation.